Provider Demographics
NPI:1669764791
Name:BERGER, KINLEY C (MD)
Entity type:Individual
Prefix:DR
First Name:KINLEY
Middle Name:C
Last Name:BERGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:172 SCHILLER
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2885
Mailing Address - Country:US
Mailing Address - Phone:331-221-9000
Mailing Address - Fax:314-645-8771
Practice Address - Street 1:1200 S. YORK
Practice Address - Street 2:2000
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126
Practice Address - Country:US
Practice Address - Phone:331-221-9002
Practice Address - Fax:331-221-3959
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36137074207V00000X
MO2011016831207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology